Organization
DEWBERRY GRAHAM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONETTA GRAHAM LPC (OWNER)
(919) 217-0061
Entity
Organization
Contact information
Practice address
6845 KNIGHTDALE BLVD, STE 104, KNIGHTDALE, NC 27545-9651
(919) 217-0061
(919) 217-0069
Mailing address
6845 KNIGHTDALE BLVD, STE 104, KNIGHTDALE, NC 27545-9651
(919) 217-0061
(919) 217-0069
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5917583
—
NC
05
—
6006458
—
NC
Enumeration date
07/03/2008
Last updated
10/30/2015
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